How To Prevent Common Medical Billing Mistakes

Medical billing and coding is a complex field that requires extensive training. While some practices and hospitals do it on their own or staff their team with qualified professionals, many practices simply can’t afford to keep medical billers and coders in-house.

This leaves medical practices with the option to hire temps or part-time employees who may or may not have adequate qualifications for the task or seek third-party vendors, such as individuals or firms that specialize in medical billing and coding services. This can get pricy, but it’s important to remember that a good billing and coding service ensures that a practice receives payment for services in full and in a timely manner.

A bad service could make all kinds of common mistakes, from duplicate billing to erroneous coding (upcoding, unbundling, mismatched codes for treatment/diagnosis, etc.). Of course, mistakes can also occur on your end. A medical practice may see delay of payment if it delivers incorrect patient information or fails to provide adequate information about diagnosis and treatment for a service to create appropriate codes.

If you want to get paid, however, you need to catch mistakes like these and avoid them whenever possible. Here are a few tips to prevent common medical billing errors.

Double Check on Your End
You have total control about the information that leaves your office, so it behooves you to take the time to double check any information you send out before it gets to your medical billing and coding specialist or service. If you’re doing medical billing in-house, you should be able to avoid errors altogether, supposing you have a knowledgeable and experienced professional on staff.

As for sending out information to your billing and coding service, you might want to institute a policy that requires two sets of eyes on every communique. This should help to ensure that all information being sent is correct, including patient name and insurance information, as well as specifications about diagnosis and treatment.

When you check and double check, you can avoid typos, insufficient information, and other errors that will hold up the payment process and potentially result in no payment at all.

Hire a Reputable Service
Finding a medical billing and coding specialist or firm probably isn’t going to be terribly difficult – if there are none in your area you’ll find that many work remotely via messenger, mail, or online communications anyway. However, finding a truly stellar service could be a harder task.

The best thing to do when you’re looking for a medical billing and coding service is turn to your network of colleagues for referral. Many will have recommendations about who to stay away from and who will offer the best service.

You’ll want to look for billing and coding services that have guaranteed turnaround times to complete coding, send bills, and follow up. A high rate of return on payment is also important. Naturally, cost can be a factor as well, so you may want to look into larger firms that can not only hire competitively, but also offer competitive pricing.

Request Reports
Before you contract with a medical billing and coding service, you might want to ask about what types of oversight they offer. Some professionals are willing to provide regular reports charting their work and the progress being made on the bills you’ve submitted, while others don’t offer any reporting or oversight.

It’s understandable that self-employed medical billing and coding specialists working from home simply might not have the capacity to generate frequent reports for clients. However, vendors that offer transparency not only appear more trustworthy, but if something is going wrong with billing, clients have a chance to catch and correct it. You’ll have to decide for yourself how important this aspect of service is.

Make Changes if Necessary
You’ll know when errors are being made by your medical billing and coding service because bills will be rejected, payments will be delayed, and you’ll find yourself constantly calling to find out what is causing the holdup. Hiring a reputable service provider staffed by knowledgeable and experienced professionals should help you to avoid this outcome, but if you notice problems, it may be time to look for a new medical billing and coding service provider. Don’t be afraid to shop around until you find a vendor that offers error-free service.